Motor vehicle accidents, suicides, and assaults in epilepsy

Kwon, Chang Hee; Liu, M.; Quan, Hude; Thoo, V.; Wiebe, Samuel; Jetté, Nathalie

doi:10.1212/wnl.0b013e31820e7b3b

Cited by 49 publications

(38 citation statements)

References 26 publications

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“…Instead, there were differences among the articles using accident, with three of the five articles holding the position there was no intent behind some events and were the result of random chance. 21-23 The other two articles opposing this position were in agreement with the articles using the term crash. 19,20,24,25 This discrepancy on the meaning of intent among the articles using the term accident indicates accident is not just a redundant term to crash; it has some defining characteristics distinct from the meaning of the word crash.…”

Section: Discussionsupporting

confidence: 68%

“…19,20 Three of the articles using accident did consider the possibility of chance and that certain circumstances can be viewed as random and unpreventable. 21-23 When looking at the article that used crash only and the one that used crash and accident interchangeably, strong similarities were seen between these two articles. 24,25 Not too surprisingly, they both stood on the side that events are predictable and preventable, but more interesting was that they were in the company of two of the articles strictly using the word accident.…”

Section: Resultsmentioning

confidence: 99%

“…19,21, 24,25 Conversely, two of the three articles that acknowledge an element of chance also acknowledged the marginalized populations. 20,22,23 …”

Section: Resultsmentioning

confidence: 99%

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When a Crash Is Really an Accident

Knechel¹

2015

Journal of Trauma Nursing

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Background The debate over using the word accident has encouraged some groups to adopt the word crash, while other groups retain using accident. This article addresses the inconsistent and interchangeable use of the terms accident and crash. Design This conceptual analysis used a Critical Review Method, with Critical Theory as the theoretical framework. Methods A literature search was conducted in Medline and CINAHL for any papers published through 2011. An extensive review of literature was followed by purposive sampling of articles published in 2011 across countries, disciplines, and contexts. Results Forty-seven articles were read in entirety, resulting in two themes for accident: intent and injury. Seven articles were critically analyzed for intent, injury, and underrepresented margins of society (five articles using the term accident, one article using crash and accident interchangeably, and one using crash only). There was congruency on injury across all seven articles. Results were mixed for intent and the incorporation of marginalized people. Conclusion Although there is evidence that the use of the word accident should be maintained when the event could not have reasonably been prevented, the theoretical framework highlights this will likely perpetuate the conceptual confusion. The recommendation is to: 1) identify the mechanism of injury, 2) identify event as intentional vs. non-intentional, and 3) identify event as preventable vs. non-preventable.

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Section: Discussionsupporting

confidence: 68%

Section: Resultsmentioning

confidence: 99%

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When a Crash Is Really an Accident

Knechel¹

2015

Journal of Trauma Nursing

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“…Restrictions for drivers with epilepsy have probably contributed to death rates from motor vehicle accidents not being significantly higher than that of the general population in certain countries 7 . However, the role of public health and education measures in reducing mortality from non-vehicle accidents in patients with epilepsy is uncertain.…”

Section: Introductionmentioning

confidence: 99%

Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study

et al. 2013

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SummaryBackgroundEpilepsy is associated with high rates of premature mortality, but the contribution of psychiatric comorbidity is uncertain. We assessed the prevalence and risks of premature mortality from external causes such as suicide, accidents, and assaults in people with epilepsy with and without psychiatric comorbidity.MethodsWe studied all individuals born in Sweden between 1954 and 2009 with inpatient and outpatient diagnoses of epilepsy (n=69 995) for risks and causes of premature mortality. Patients were compared with age-matched and sex-matched general population controls (n=660 869) and unaffected siblings (n=81 396). Sensitivity analyses were done to investigate whether these odds differed by sex, age, seizure types, comorbid psychiatric diagnosis, and different time periods after epilepsy diagnosis.Results6155 (8.8%) people with epilepsy died during follow-up, at a median age of 34·5 (IQR 21·0–44·0) years with substantially elevated odds of premature mortality (adjusted odds ratio [aOR] of 11·1 [95% CI 10·6–11·6] compared with general population controls, and 11·4 [10·4–12·5] compared with unaffected siblings). Of those deaths, 15·8% (n=972) were from external causes, with high odds for non-vehicle accidents (aOR 5·5, 95 % CI 4·7–6·5) and suicide (3·7, 3·3–4·2). Of those who died from external causes, 75·2% had comorbid psychiatric disorders, with strong associations in individuals with co-occurring depression (13·0, 10·3–16·6) and substance misuse (22·4, 18·3–27·3), compared with patients with no epilepsy and no psychiatric comorbidity.InterpretationReducing premature mortality from external causes of death should be a priority in epilepsy management. Psychiatric comorbidity plays an important part in the premature mortality seen in epilepsy. The ability of health services and public health measures to prevent such deaths requires review.FundingWellcome Trust, the Swedish Prison and Probation Service, and the Swedish Research Council.

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“…There is no coherent conclusion as to whether PWE drivers have a higher or similar risk when compared to drivers in the general population [4][5][6][7][8][9][10][11]. One scientific approach to propose suitable criteria for driving by PWE was reported in Europe [12].…”

Section: Introductionmentioning

confidence: 99%

Estimating the risk of fatal traffic accidents posed by drivers with epilepsy in Japan: A comparison with traffic accidents caused by sudden death of occupational drivers

Ban

Kawai

Nambu

et al. 2018

E&S

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Purpose: Pr oper judgement of the aptitude of people with epilepsy (PWE) for dr iving is a cr itical issue, both medically and socially. One thus far reported approach is a quantitative comparison of the risk of fatal traffic accidents caused by PWE drivers and that by subgroups of drivers in the general population. We propose a new approach that compares the risk posed by PWE drivers and that by sudden death of occupational drivers, and the maximum driving time for PWE based on that comparison. Method: The r isk of fatal tr affic accidents was estimated using four var iables. The value assigned to each variable was determined using reports and statistics. Results: The r isk of fatal tr affic accidents caused by sudden death of occupational dr iver s was estimated to be 7.6×10 -5 /year, 4.9×10 -5 /year, and 1.7×10 -5 /year for large-sized, mid-sized and normalsized vehicles. The risk of fatal traffic accidents caused by PWE drivers was estimated to be 5.3×10 -5 / year and 3.2×10 -5 /year for PWE with seizure-free periods of 1 year and 2 years, respectively. The maximum acceptable driving time for PWE having a 2-year seizure-free period at the equivalent risk caused by sudden death of occupational drivers of mid-sized vehicles was estimated to be 304 min/week. Conclusion: The r isk of fatal tr affic accidents caused by PWE dr iver s can be evaluated by comparing to that caused by sudden death of occupational drivers. Such risk posed by PWE drivers having a 2-year seizure-free period was less than that caused by sudden death of occupational drivers of midsized vehicles. Assuming that the society accepts the latter risk, PWE may be permitted to drive for an estimated maximum time at the equivalent risk of causing a fatal accident.

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Motor vehicle accidents, suicides, and assaults in epilepsy

Abstract: In this cohort-controlled population-based study, once important medical and psychiatric comorbidities were adjusted for, people with epilepsy were not more likely to attempt suicide or experience MVAs, but were still more likely to be assaulted compared to those without epilepsy.

Cited by 49 publications

References 26 publications

When a Crash Is Really an Accident

When a Crash Is Really an Accident

Premature mortality in epilepsy and the role of psychiatric comorbidity: a total population study

Estimating the risk of fatal traffic accidents posed by drivers with epilepsy in Japan: A comparison with traffic accidents caused by sudden death of occupational drivers

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